entrants who may develop active disease later in life. After consider- able thought and investigation, B.C.G. vaccination was extended to school leavers in March. For actual cases of the disease it has now been shown that in a large proportion of cases out-patient therapy is at least as good as institutional treatment. It is gratifying to note that in complete contrast to the past there is now no waiting list for hospital admission and indeed during the year 153 tuberculosis beds were made available for other uses. The not inconsiderable institu- tional resources are reserved for those not responding to out-patient therapy, for acutely ill cases, for those where the diagnosis is in doubt, and for those in need of surgical intervention. In the execution of this policy there has been a high degree of co-operation between Government and voluntary agencies concerned with the problem, par- ticularly the Hong Kong Anti-Tuberculosis and Thoracic Diseases Association and the Haven of Hope Sanatorium. The Government Chest Service maintains the B.C.G. vaccination and out-patient treatment programme, while the voluntary agencies, aided by substantial Govern- ment subventions, maintain most of the hospitals.
35. To keep pace with the rapid changes which are occurring in the fields of treatment and prevention of tuberculosis, close liaison is maintained with agencies outside the Colony. At the moment there are underway, in collaboration with the Medical Research Council of the United Kingdom, no less than four major lines of research. The results of these studies should eventually result in much improved treatment regimens and considerable financial savings,
36. Preliminary results of a joint study with the World Health Organization concerning B.C.G. vaccination of the new-born are now available and the study continues on a follow-up basis.
Case Finding
37. In the past the large number of patients attending the Chest Clinics made large-scale case-finding undesirable. With improved facili- ties and the decrease in the number of patients, case-finding has come to play an increasingly important role. Emphasis is being placed on symptom-motivated patients and health education techniques are being used to ensure a proper understanding of the disease. A mass Health
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Education Campaign lasting 1 week was held in December. The theme of the campaign was: 'If you have a chronic cough lasting more than one month, please have a chest X-Ray',
Mortality and Morbidity
38. During the year the number of deaths fell slightly. The great majority of deaths continued to occur in elderly males who had been suffering from tuberculosis for many years and who died of its sequelae rather than from active tuberculosis. Tuberculosis mortality by age and sex is shown in Figure 5.
FOURE 3
'TUBERCULOSIS MORTALITY BY AGE & BEM 1958 - 1960 AND 1968 - 1970
39. During the year the notification rate fell to 255.7 per 100,000
of the population. Figure 6 shows the changes which have taken place in age and sex specific notification rates. There have been marked reductions in the incidence of the disease during childhood. There has
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